Stenosis severity indices cannot reflect lumen loss in stent trials

EuroIntervention 2018;14:838. DOI: 10.4244/EIJ-D-17-01073L

Francesco Lauri
Francesco Maria Lauri*, MD; Fernando Macaya, MD; Hernán Mejía-Rentería, MD
Department of Cardiology, Hospital Clínico San Carlos, IDISSC, Madrid, Spain

We read with interest the article from Asano et al1 reporting the functional equivalence, as measured by quantitative flow ratio (QFR, a novel adenosine-free angiography-based fractional flow reserve [FFR]), of two tested stents. This is a substudy of the simultaneously published PIONEER randomised trial2, which failed to demonstrate non-inferiority in terms of late lumen loss of a novel sirolimus-eluting stent with a biodegradable PLGA-polymer coating and an electrografting base layer on a thin-strut (80 µm) cobalt-chromium platform (BuMA™; SINOMED, Tianjin, China) when compared to the contemporary durable polymer zotarolimus-eluting stents (ZES). The rate of restenosis (>50%) and 12-month clinical endpoints ...

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